Dhaka, Bangladesh
Things that help (and hinder) your chances of conceiving

Things that help (and hinder) your chances of conceiving

For some people, getting pregnant happens quickly, effortlessly, and without much planning at all. For others, it can be long and exhausting process, plagued by failed attempts and costly intervention. Struggling to conceive is surprisingly common. It's estimated one in six couples experience fertility problems. Infertility is defined as having 12 months of regular, unprotected sex and failing to become pregnant. For women over 35, the threshold is six months instead of 12. But your chances of being able to conceive - both naturally and with the help of IVF - depend on a few things, including your age and overall health, says Karin Hammarberg, fertility expert and senior research fellow at Monash University. "A lot of it is up to nature, but it's possible to do some things to help yourself have a baby if you want one," she says. Time is of the essence While many people are choosing to have children later in life, there's no question age remains the single most important factor when it comes to your ability to conceive. A woman's fertility starts to slowly decline in her early 30s, and this accelerates at about the age of 35. By the age of 40, her chances of a successful pregnancy have essentially halved. "For couples trying to conceive where the woman is 35 or younger, their monthly chance of getting pregnant is about 20 per cent, or one in five," Dr Hammarberg says. "But by age 40, their monthly chance drops to 5 per cent, and only half of couples will successfully conceive within a year." And it's not just a woman's age that matters. Dr Hammarberg says although men continue to produce sperm throughout their life (unlike women whose eggs are finite), the quality of their sperm starts to decline at around the age of 45. "There's evidence it takes much longer for a woman to conceive if the man is over 45. And there are increased risks of adverse outcomes in the offspring if they do conceive," she says. Risks of miscarriage, pregnancy complications, gestational diabetes and birth defects also increase as a woman gets older. "Down syndrome is much more common, for example, and that's part of the process of ageing eggs - chromosomal abnormalities increase," Dr Hammarberg says. Age is also the most important factor when it comes to IVF success, particularly the age of the woman undergoing treatment. As with natural conception, research shows women who start IVF before the age of 35 have the highest rates of success (33 per cent have a baby as a result of their first cycle), while women aged 40 and above have just an 11 per cent chance of taking home a baby after their first cycle, increasing to 30 per cent after eight cycles. "There's a misconception that if you can't have a baby naturally when you're a bit older, you can always have IVF. But IVF can't overcome age-related infertility," Dr Hammarberg says. "Certainly, after 40, it's a real battle to get anyone pregnant with IVF. And if you do conceive (above the age of 40), about half of those pregnancies will miscarry." Having children young isn't for everyone and there are lots of valid reasons for choosing to have kids later in life. But understanding the relationship between age and fertility can help couples make the decision that's right for them, says Dr Hammarberg. Healthy diet and lifestyle are key The best predictor for a healthy embryo is a healthy egg and sperm - that goes for both natural conception and IVF. Research has shown a healthy diet in the year prior to getting pregnant is associated with a lower rate of birth defects. Both women and men are recommended to eat well, exercise regularly, and practice healthy lifestyle habits when trying to fall pregnant. "That means a nutritious diet that contains fresh food and as little processed food as possible; drinking in moderation; not smoking; being in the healthy weight range; and also exercising," Dr Hammarberg says. "All of these things improve our general health, but they also simultaneously improve our reproductive health." The best way for women to ensure they are getting enough vitamins and minerals in the lead up to pregnancy is by eating a healthy, well-balanced diet, she says. "One thing women should take if they're planning pregnancy is folate supplements … and iodine is important as well. "Apart from that, most women don't need any supplements if they have a wholesome diet." When it comes to lifestyles factors, research shows cigarette smoking causes damage to eggs and sperm which can then go on to affect the health of an unborn baby. To avoid this, it is recommended that people who smoke kick the habit a few months before trying to conceive. The link between alcohol and fertility is less clear (it is not known what levels of consumption are safe, if any), but research shows that even drinking lightly can reduce the likelihood of conception. For that reason, the National Health and Medical Research Council recommends women trying to get pregnant should not drink alcohol at all. Weight plays a role Being overweight or obese can also affect fertility in both women and men. In women, excess weight can disrupt the finely-tuned hormonal balance that regulates the menstrual cycle and stimulates ovulation (releasing an egg from the ovaries). "Often women who carry a lot of excess weight either don't have periods at all or they have irregular or infrequent periods. That makes it really difficult to pinpoint ovulation," Dr Hammarberg says. Being underweight can also affect a woman's fertility by causing hormone imbalances and problems with ovulation. Men who are overweight or obese are at increased risk of infertility due to a combination of factors including hormonal changes, problems with erection, and other obesity-related health conditions. Since the environment in which an egg and sperm develops can affect the health of a baby, both parents being a healthy weight prior to conception boosts the baby's chances of being healthy at birth and into adulthood. The good news is that even a modest weight loss (five to 10 per cent of one's body weight) improves your fertility and the chance of conceiving. Understanding your fertile window For couples using natural conception, finding a woman's "fertile window" is essential to successful baby making. Conception is only possible from about five days before ovulation (the lifespan of sperm) through to the day of ovulation (the 24-hour lifespan of the egg). Ovulation happens approximately 14 days before a woman's next period. In a 28-day menstrual cycle (the length of cycles can vary), the first day of your period being day one of the cycle, ovulation typically occurs around day 14. If a woman has sex six or more days before she ovulates, the chance she will get pregnant is virtually zero. And 12 to 24 hours after she ovulates, a woman is no longer able to get pregnant during that cycle. "It's such a simple thing to get people to understand this part of reproduction. It's not an intervention, it doesn't cost anything. It's just a bit of knowledge," Dr Hammarberg says. She says it's important women trying to fall pregnant are able to recognise how their body changes when ovulation approaches. "Learning a little about the menstrual cycle and how it works can absolutely improve your chances of conceiving." The Your Fertility website has an ovulation calendar which can help women work out their most fertile days. We've tried everything … what's next? While living a healthy lifestyle will improve your general health and fertility prospects, it does not slow the effects of ageing, nor does it address all underlying causes of infertility. Having difficulty conceiving can also be caused by ovulation disorders, blocked fallopian tubes, endometriosis, polycystic ovarian syndrome, premature menopause, thyroid problems, sperm defects and sexually transmitted infections, among other things. After 12 months of trying to conceive (or six months if you're a woman over 35), you should make an appointment with your GP. "They will do some preliminary tests, like a semen analysis, and take a reproductive history, and there might be clues in there about your fertility," Dr Hammarberg says. "At some point, if things don't happen, you will eventually be referred on to a fertility specialist." Dr Hammarberg says it's important that both partners optimise their health before trying to conceive. "Studies show if partners do it together, they're twice as likely to succeed," she says. "Whatever needs to be done in terms of optimising health, it should be equally recommended to male and female partners."

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